Posted by viridis on August 25, 2002, at 16:34:19
In reply to adderal and other questions » viridis, posted by hildi on August 25, 2002, at 14:13:46
Hi Hildi,
Your situation sounds very similar to mine. I went through several doctors who insisted that SSRIs (or Wellbutrin) were the way to go. I used Prozac for extended periods (several months) at various times. In each case, I would experience severe anxiety for several weeks, which eventually turned into a sort of wired, yet emotionally blunt state of mind in which I really didn't enjoy or care about anything and could rarely sleep properly. This was the case at any dose I tried (even as low as 10 mg/day).
I was prescribed short-term Xanax a few times when my anxiety really went through the roof, and it helped tremendously (especially for sleep). However, the doctor who prescribed it was afraid of "addiction" and so wouldn't allow extended use.
When I finally found my current pdoc (after my bad experience with Wellbutrin), he did try very low-dose Zoloft (starting at 12.5 mg/day) a few weeks after initiating the Klonopin/occasional Xanax plan. I had a reaction that sounds much like yours: drastic mood changes, unpredictable anger (uncharacteristic for me), shakiness, etc. After about a week of this, I called the dr. and told him I'd have to stop taking it. He said yes, stop -- this isn't the drug for you. We later discussed this more, and I asked about the possible significance of my reaction to Zoloft. His response was simply that different people react differently, and that I didn't seem like a good candidate for further SSRI experiments. So, I haven't tried any since.
I had been tentatively diagnosed with ADD a couple of times before by therapists, and was intending to bring this up, but he beat me to it by suggesting the possibility of psychostimulants (after some fairly detailed questioning about ADD-type symptoms and history). He gave me some samples of Provigil (=modafinil), and said this was the mildest of the pstims. I tried the Provigil for a few weeks, and it was OK -- stimulating, not particularly anxiogenic, but not really much help with the focus problems.
When I told my pdoc this, he wasn't too surprised, and said that in his experience Provigil is kind of hit-or-miss, although it can be good for some. So, we tried Adderall (5-10 mg/day) and that made a big difference. I was able to concentrate better, my mood improved (I was still experiencing transient depression, although nothing like pre-Kolonopin), and I generally felt more enthusiastic. This was a few months ago (I started the Klonopin about a year ago) and I still get the same effects at the same doses. I do skip the Adderall for a day or so here and there with no problem.
The Neurontin was added somewhere in the middle of this. I'm not sure it does a whole lot, but my pdoc feels that it probably adds some background stability. Since I've had no side effects (except mild euphoria the first couple of times I took it) I'm sticking with it for now. Again, though, I think the Klonopin is the key player, with the Adderall further improving mood and concentration, and a bit of Xanax now and then for especially stressful situations.
I'm pretty happy with this mix, and everything except the Neurontin is available as generic, so it's a relatively inexpensive way to go.
Hope this helps, and good luck!
poster:viridis
thread:117297
URL: http://www.dr-bob.org/babble/20020821/msgs/117732.html